Understanding GAD - and the Symptoms
Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. Individuals with GAD find it difficult to control their worry. They may worry more than seems warranted about actual events or may expect the worst even when there is no apparent reason for concern.
GAD is diagnosed when a person finds it difficult to control worry on more days than not for at least six months and has three or more symptoms. Learn more about symptoms. This differentiates GAD from worry that may be specific to a set stressor or for more limited period of time.
GAD affects 6.8 million adults, or 3.1% of the U.S. population, in any given year. Women are twice as likely to be affected. The disorder comes on gradually and can begin across the life cycle, though the risk is highest between childhood and middle age. Although the exact cause of GAD is unknown, there is evidence that biological factors, family background, and life experiences, particularly stressful ones, play a role.
Sometimes just the thought of getting through the day produces anxiety. People with GAD don’t know how to stop the worry cycle and feel it is beyond their control, even though they usually realize that their anxiety is more intense than the situation warrants. All anxiety disorders may relate to a difficulty tolerating uncertainty and therefore many people with GAD try to plan or control situations. Many people believe worry prevents bad things from happening so they view it is risky to give up worry. At times, people can struggle with physical symptoms such as stomachaches and headaches.
When their anxiety level is mild to moderate or with treatment, people with GAD can function socially, have full and meaningful lives, and be gainfully employed. Many with GAD may avoid situations because they have the disorder or they may not take advantage of opportunities due to their worry (social situations, travel, promotions, etc). Some people can have difficulty carrying out the simplest daily activities when their anxiety is severe.
A number of types of treatment can help with GAD. Supportive and interpersonal therapy can help. Cognitive behavioral treatment (CBT) has been more researched and specifically targets thoughts, physical symptoms and behaviors including the over-preparation, planning and avoidance that characterizes GAD. Mindfulness based approaches and Acceptance Commitment Therapy have also been investigated with positive outcome. All therapies (sometimes in different ways) help people change their relationship to their symptoms. They help people to understand the nature of anxiety itself, to be less afraid of the presence of anxiety, and to help people make choices independent of the presence of anxiety. The adult CBT treatments for GAD have been modified for children and teens and show positive outcomes.
There are a number of medication choices for GAD, usually the SSRIs either alone or in combination with therapy.
Relaxation techniques, meditation, yoga, exercise, and other alternative treatments may also become part of a treatment plan.
Other anxiety disorders, depression, or substance abuse often accompany GAD, which rarely occurs alone; co-occurring conditions must also be treated with appropriate therapies.
Annual Review of Clinical Psychology Vol. 9:275-297 (Volume publication date March 2013)
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